ipratropium / albuterol
Ipratropium bromide/albuterol sulfate is a combination inhalation solution made up of two different bronchodilators. This combination is used to treat chronic obstructive pulmonary disease (COPD) in adults. It's inhaled through a nebulizer, typically 4 times a day. Side effects of this medication include lung problems, sore throat, and chest pain. The brand name Duoneb has been discontinued, so ipratropium/albuterol solution is only available as a generic.
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What is Ipratropium/albuterol solution?
What is Ipratropium/albuterol solution used for?
Treatment of shortness of breath in people with chronic obstructive pulmonary disease (COPD) who need more than one bronchodilator
How Ipratropium/albuterol solution works
Ipratropium/albuterol solution is a combination of two medications that work together to make it easier to breathe.
Ipratropium is a short-acting muscarinic antagonist (SAMA), a type of anticholinergic medication. It works by blocking a chemical called acetylcholine from squeezing (tightening) the airways in your lungs.
Albuterol is a short-acting beta-agonist (SABA). It works by relaxing the muscles in your lungs to open up your airways.
Drug Facts
What are the side effects of Ipratropium/albuterol solution?
Common Side Effects
- Lung problems (6%)
- Sore throat (4%)
- Chest pain (3%)
- Bronchitis (2%)
- Diarrhea (2%)
- Urinary tract infection (2%)
Other Side Effects
- Pain
- Indigestion
- Nausea
- Leg cramps
- Pneumonia
Serious Side Effects
- Serious allergic reaction: hives, swelling of your face, lips, or tongue, difficulty breathing
- Sudden narrowing of your airways: difficulty breathing, wheezing, chest pain or tightness, cough
- Heart problems: dizziness, fatigue, weakness, tremor, irregular heartbeat, worsening symptoms of heart problem you already have
Source:Â DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Body aches or pain
chills
cough producing mucus
difficulty with breathing
ear congestion
headache
loss of voice
tightness in the chest
unusual tiredness or weakness
Less common
Bladder pain
bloody or cloudy urine
blurred vision
burning while urinating burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
congestion
difficult, burning, or painful urination
dizziness
fainting
fast, slow, irregular, pounding, or racing heartbeat or pulse
frequent urge to urinate
general feeling of discomfort or illness
hoarseness
increased sputum
joint pain
loss of appetite
lower back or side pain
muscle aches and pains
nervousness
noisy breathing
pain or tenderness around the eyes and cheekbones
pounding in the ears
shakiness in the legs, arms, hands, or feet
shivering
sweating
swelling
tender, swollen glands in the neck
trembling or shaking of the hands or feet
trouble sleeping
trouble swallowing
voice changes
vomiting
Incidence not known
Chest discomfort
decrease in the frequency of urination
decrease in urine volume
difficulty in passing urine (dribbling)
itching skin
large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
pain or discomfort in the arms, jaw, back, or neck
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
redness of the skin
welts
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Less common
Acid or sour stomach
bad, unusual, or unpleasant (after) taste
belching
change in taste
difficulty with moving
indigestion
muscle pain or stiffness
stomach discomfort, upset, or pain
voice changes
Incidence not known
Bigger, dilated, or enlarged pupils (black part of the eye)
blindness
change in near or distance vision
decreased vision
difficulty in focusing eyes
dry throat
increased sensitivity of the eyes to light
itching, redness, tearing, or other sign of eye irritation not present before use of this medicine or becoming worse during use
lack or loss of strength
noisy breathing
redness of the white part of the eyes or inside of the eyelids
swelling of the eye
swelling or inflammation of the mouth
tearing
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Ipratropium/albuterol solution
Pros
Starts working within minutes
More convenient to use a combination of two bronchodilators in a single medication
Available as a lower-cost generic
Cons
Need to use with a nebulizer machine, which can be inconvenient
Takes up to 15 minutes to receive the whole dose
Might not be a good option for those with heart problems
Pharmacist tips for Ipratropium/albuterol solution
Carefully read the instructions on how to use ipratropium/albuterol solution with a nebulizer machine to avoid wasting the medication or accidentally hurting yourself (e.g., eye problems, changes in vision). Ask your provider or pharmacist if you have any questions about using the medication.
How to set up your nebulizer: When you're ready for your dose, remove one vial from the foil pouch. Twist the cap off the vial to open, and then squeeze the contents into the nebulizer container. Connect the nebulizer to your mouthpiece or face mask, and then connect the nebulizer to the compressor.
Sit in a comfortable, upright position during your breathing treatment. Using the mouthpiece or face mask, breathe as calmly, deeply, and evenly as possible until there's no more mist in the nebulizer. This can take up to 15 minutes.
Keep the vials of ipratropium/albuterol solution in the original foil pouch and store at room temperature. After opening the pouch, keep any unused vials in the foil pouch to protect them from light.
Clean your nebulizer after each time you use it. This helps prevent lung infections that can happen if you use a nebulizer machine that isn't cleaned well.
Call your provider if your breathing gets worse or doesn't improve after using ipratropium/albuterol solution. Also contact your provider if you're using ipratropium/albuterol solution more often than usual. These could be signs you need a change in your treatment plan for your breathing problem.
Ipratropium/albuterol solution can interact with other medications. Some of these interactions can make your medications not work as well or raise your risk of harmful side effects. Some examples include blood pressure medications (e.g., beta blockers) and antidepressants (e.g., tricyclic antidepressants). Don't start any new medications while taking ipratropium/albuterol solution without asking your provider or pharmacist first whether the combination is safe to take.
Frequently asked questions about Ipratropium/albuterol solution
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What are the risks and warnings for Ipratropium/albuterol solution?
Ipratropium/albuterol solution can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Narrowing of your airways (bronchospasm)
Though extremely rare, ipratropium/albuterol solution can sometimes cause a muscle spasm in your lungs (bronchospasm). This can lead to difficulty breathing, wheezing, cough, and chest discomfort. If you become short of breath after using ipratropium/albuterol solution, get medical attention right away.
Heart problems
Risk factors: High blood pressure | Heart failure | Heart rate or rhythm problems | Using more ipratropium/albuterol solution than recommended
Although rare, ipratropium/albuterol solution can cause changes in your blood pressure and heart rate. If you have high blood pressure or other heart problems, ipratropium/albuterol solution can make it worse, especially if you take the medication more often than instructed. Watch out for worsening signs and symptoms of your heart condition. Tell your provider if you develop dizziness, fatigue, tremor, rapid heartbeat, or weakness while taking ipratropium/albuterol solution.
Eye problems
Risk factors: History of glaucoma | Exposure of ipratropium/albuterol solution to eyes | Using the nebulizer machine incorrectly
Though not common, using ipratropium/albuterol solution can raise the pressure in the eyes. Sometimes, this can cause or worsen glaucoma. Talk to your eye provider before using ipratropium/albuterol solution if you have glaucoma or other eye problems. Also speak with them if you notice any changes to your vision while using the medication. Never spray ipratropium/albuterol solution in your eyes because this could cause eye pain, discomfort, blurry vision, and other vision changes.
Trouble urinating
Risk factors: Enlarged prostate | Bladder-neck obstruction (blockage)
Ipratropium/albuterol solution should be used cautiously in people who have prostate problems, because it can worsen this condition and lead to difficulty urinating. Contact your provider if you notice difficulty urinating while using this medication.
Severe allergic reactions
Severe allergic reactions to ipratropium/albuterol solution are possible, including life-threatening reactions like facial swelling, shock, and anaphylaxis (closing of the throat). Get medical attention right away if you notice hives, rash, red skin, swelling of the lips or tongue, or difficulty breathing after using ipratropium/albuterol solution.
Low potassium in the blood
Risk factors: Using ipratropium/albuterol solution too much
Ipratropium/albuterol solution can cause the potassium levels in your blood to drop too low if you overdose by using too much ipratropium/albuterol solution. Symptoms of low potassium include tiredness, weakness, muscle cramps or spasms, a racing heart, and a "pins and needles" feeling in your hands and feet. Don't take more ipratropium/albuterol solution than prescribed. If ipratropium/albuterol solution isn't helping your breathing get better, seek medical help right away.
Ipratropium/albuterol solution dosage forms
| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 3ml of 0.5mg/3mg/3ml | 1 vial | $41.95 | $41.95 |
Typical dosing for Ipratropium/albuterol solution
Each 3 mL vial contains 0.5 mg of ipratropium and 3 mg of albuterol.
The typical dose is 1 vial inhaled through the mouth by nebulization 4 times per day, and up to 2 additional doses (for a total maximum of 6 doses per day) if needed for wheezing or shortness of breath.
More on Ipratropium/albuterol solution dosage forms
Interactions between Ipratropium/albuterol solution and other drugs
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Acebutolol
- Amineptine
- Amitriptyline
- Amitriptylinoxide
- Amoxapine
- Arotinolol
- Atenolol
- Atomoxetine
- Befunolol
- Betaxolol
- Bevantolol
- Bisoprolol
- Bopindolol
- Bucindolol
- Bupranolol
- Carteolol
- Carvedilol
- Celiprolol
- Clomipramine
- Clozapine
- Desipramine
- Dibenzepin
- Dilevalol
- Doxepin
- Esmolol
- Glucagon
- Glycopyrrolate
- Glycopyrronium Tosylate
- Imipramine
- Iobenguane I 123
- Labetalol
- Landiolol
- Levalbuterol
- Levobunolol
- Lofepramine
- Melitracen
- Mepindolol
- Methacholine
- Metipranolol
- Metoprolol
- Nadolol
- Nebivolol
- Nortriptyline
- Opipramol
- Oxprenolol
- Penbutolol
- Pindolol
- Practolol
- Propranolol
- Protriptyline
- Quetiapine
- Revefenacin
- Scopolamine
- Secretin Human
- Sotalol
- Talinolol
- Tertatolol
- Tianeptine
- Timolol
- Tiotropium
- Trimipramine
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Betel Nut
- Digoxin
How much does Ipratropium/albuterol solution cost?
Ipratropium/albuterol solution contraindications
Allergy to atropine or other similar medications (e.g., anticholinergic)
What are alternatives to Ipratropium/albuterol solution?
Treatment of shortness of breath in people with chronic obstructive pulmonary disease (COPD) who need more than one bronchodilator
Maintenance treatment of chronic obstructive pulmonary disease (COPD) in adults
Maintenance treatment for chronic obstructive pulmonary disease (COPD) in adults who need more than one bronchodilator
Ipratropium/albuterol solution images
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References
Best studies we foundAmerican Lung Association. (2023). How to clean a nebulizer.
American Lung Association. (2023). How to use a nebulizer.
American Thoracic Society. (2020). Nebulizer breathing treatments at home.
Campbell, S. (1999). For COPD a combination of ipratropium bromide and albuterol sulfate is more effective than albuterol base. Archives of Internal Medicine.
Hsu, E., et al. (2023). Beta2-agonists. StatPearls.
Ritedose Pharmaceuticals, LLC. (2023). Ipratropium bromide and albuterol sulfate solution [package insert]. DailyMed.
Sam, C., et al. (2023). Physiology, acetylcholine. StatPearls.
U.S. Food and Drug Administration. (2022). Drug disposal: Drug take back locations.
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